Healthcare Provider Details

I. General information

NPI: 1316917263
Provider Name (Legal Business Name): NEW MADRID COUNTY AMBULANCE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2006
Last Update Date: 01/03/2023
Certification Date: 01/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 US HIGHWAY 61
NEW MADRID MO
63869-9753
US

IV. Provider business mailing address

PO BOX 457
WHEELING IL
60090-0457
US

V. Phone/Fax

Practice location:
  • Phone: 573-748-5571
  • Fax: 573-748-8900
Mailing address:
  • Phone: 847-305-5236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number143006
License Number StateMO

VIII. Authorized Official

Name: MR. PATRICK GARRISON
Title or Position: DIRECTOR
Credential:
Phone: 573-748-5571